Mission of Mercy Site Evaluation



[pic]

Mission of Mercy Site Requirements

Originating in Virginia and spreading throughout the United States, more than 85 Mission of Mercy dental programs have been conducted since 2000 to provide free dental care to local area residents who otherwise are unable to receive such care. The Michigan Dental Association Foundation is proud to be looking for sites for our MOM. A MOM program serves two purposes. To address the patients’ most pressing dental problems and relieve them of their pain; and, to bring awareness to the increasing problem of access to oral health care and the government’s responsibility to address the situation so residents have a long-term solution.

The MOM program was created to provide care to the un-insured, the under-insured or those who otherwise have difficulty getting to a dentist on an annual basis. However, anyone who attends and does not have any medically compromising condition that would prohibit them from receiving care will be seen on a first-come, first-served basis. Children and adults alike are welcome. Treatment being offered will include diagnosis by a dentist, fillings, extractions, limited partial and full dentures, and cleanings. Everyone will be educated on the importance of dental health care and how to take care of their teeth.

Our goal is to provide dental care to approximately 1,500 patients for a total of $1,000,000 in free dental care. It will take 1,300-plus volunteers and more than $200,000 in funding including in-kind contributions to make it happen.

This program is run solely by volunteers. No one is being paid to provide care or reimbursed for their time.

LEAD/CO-LEAD VOLUNTEER REQUREMENTS:

• Must be dentists licensed in the state of Michigan who are in good standing with local component, Michigan Dental Association and Michigan Board of Dentistry

• Must have written statement from component Executive Committee and/or President as to the support of the program

• Must fulfill all responsibilities within set deadlines

ITINERARY:

• Day 1: Set-up 7 a.m. – 3 p.m. (or any 6 – 8 hour period that day)

• Day 2: Clinic Open 6 a.m. – 5:30 p.m. (The first volunteers will arrive around 4:30 a.m.)

• Day 3: Clinic Open 6 a.m. – 5:30 p.m. (The first volunteers will arrive around 4:30 a.m.)

• Day 4: Tear-down (7 a.m. – 3 p.m. (or any 6 – 8 hour period that day)

FACILITY REQUIREMENTS:

• 30,000– 35,000 square feet

o 25,000 square feet for clinical space (ideally one space but it is possible to break this into two smaller sections)

o 5,000 – 7,500 square feet for patient registration and waiting areas

• Large room/area for volunteer meals (seating for 350-400 at a time)

• Classroom for Central Office Hub which will require electricity for 6-8 computers, copier and wireless Internet connection (close proximity to clinic floor is best).

• Access to water (a simple garden hose from a restroom to the lab and another to sterilization is all that is needed; the dental units utilize a self-contained system of distilled water)

• Access to sewer drainage (contaminated water will go into here from sterilization and from the dental unit suction system after it goes through an amalgam separator)

• 3-phase electrical access (we can bring in generators if need be)

• Either in house compressed air or the ability to utilize air compressors

• Ability to use fork lifts throughout the space; can make due with pallet jacks if need be

• Ability for patients to wait outside overnight — we will bring in security and portable toilets

• 800 parking spaces

Additionally, we will need 175 8-foot tables as well as folding chairs/other seating for 1,000 people. Basic pipe and draping will also be needed (if facility can’t provide MDA does have a contact for pipe and drape).

FOOD AND BEVERAGES:

Must provide food and beverage for patients waiting in line — usually overnight, as well as feeding volunteers who are working. With so many volunteers and patients this is one of the largest expenses and food must be able to be ordered or brought in at reasonable prices, if not donated.

OTHER CONSIDERATIONS:

• On-site and overnight security must be provided or the venue allowing for volunteer security obtained by the local lead committee

• Hotel(s) in close proximity to house volunteers (approximately 350 rooms per night).

• Portable toilets placed outside the venue will be necessary for patients waiting in line.

• Use of audio visual equipment on clinic floor and volunteer lounge as required.

• Loading dock off or near the clinic floor to unload equipment from a semi-truck.

Bio-waste, including anything with blood on it and/or extracted teeth or bone fragments, will be disposed of in properly marked containers (red bagged) and picked up by a certified bio-waste disposal service.

For more information about a typical Mission of Mercy program, visit the Michigan Dental Association Foundation website at .

CONTACT INFORMATION:

Nancy Maier, executive director, Stephen R Harris DDS, Chair

Michigan Dental Association Foundation MDAF Mission of Mercy

734-765-1197 248-478-4755

nmaier@ steve@

Mission of Mercy Potential Site Evaluation

Please type or print all information

|Dentist submitting proposal: (this dentist must be one of the co-chairs for the | |

|program and be licensed in the state of Michigan, in good standing with hosting | |

|component, the Michigan Dental Association and the Michigan Board of Dentistry) | |

|Date | |

|Village, town or city name | |

|Has the local component approved hosting a MOM? Please provide written proof of | |

|this and attach it with your submission. | |

|Will the dentists in the area be supportive or would they prefer us to go | |

|elsewhere? Please provide details. | |

|Identify a local person willing to serve as co-chair (this person must be a | |

|dentist licensed in Michigan, in good standing with their local component, the | |

|Michigan Dental Association and the Michigan Board of Dentistry. They should also| |

|know influential community people, organizations and foundations) | |

|Are there other dentists/laypeople who have relationships with major community | |

|philanthropists who can help with this program? Please identify the | |

|dentists/laypeople and list an idea of the amount of donations that could be | |

|secured from these relationships. | |

|There must be at least two local dentists who would be willing to do emergency | |

|follow-up care after the program dates if needed. Please list their names and | |

|contact information here (their names and phone numbers would not be given out to| |

|patients, care would be coordinated through MDA or another source). These | |

|dentists must be in good standing with the component, Michigan Dental Association| |

|and Michigan Board of Dentistry. | |

|Please list and describe the proposed facility(ies) (type of structure, currently| |

|in use, climate controlled, size, parking, etc) that could be used for this | |

|program. Also list contacts and contact information at each for follow-up | |

|purposes. Need a minimum of 30,000 square feet. Does it have water, three phase | |

|electric, and drainage capabilities? | |

|Is there a dental lab in the area that will help with MOM needs? Please list the | |

|name(s) of the lab(s) and contact(s) at them. | |

|Will the community be able to support the program with at least 60% of donations | |

|required –cash and in kind (food, water, etc.) - approximately $120,000? | |

|Is there a public health department, if so, would they be supportive and/or | |

|provide assistance? What does the support/assistance look like? Please provide | |

|contact names and numbers here. | |

|Is there a local EMT service who will donate their time to the program? Please | |

|provide name(s) and contact information here. | |

|Are there local employers willing to partner and support the program with | |

|sponsorship donations? List them along with contact information and approximate | |

|amounts projected for donations here. | |

|What overnight lodging is available in the area? List names and locations of all | |

|along with approximate distances from proposed facilities to house the MOM | |

|program. | |

|Is there a hospital nearby that would be willing to do sterilization on the first| |

|run of instruments and handle needle sticks? Please list the name or the hospital| |

|and any contacts you have at the hospital. | |

|Is there a nearby pharmacy willing to donate services and offer prescriptions at | |

|a discounted rate? Please list the names and any contacts you have at the | |

|pharmacies. | |

|What potential negatives are there if we choose this site? | |

|What else should we know about this site that makes it a good choice? | |

Questions or concerns please contact Steve Harris 248-478-4755, or Nancy Maier at 734-765-1197.

Send the completed form to the MDA Foundation electronically at foundation@

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download